motilin and Colitis--Ulcerative

An increasing body of evidence supports the concept of genetic heterogeneity within inflammatory bowel disease (IBD). In this study, a polymorphism of the motilin gene, which determines an amino acid substitution in the motilin protein, has been investigated in IBD patients. Fifty patients with ulcerative colitis (UC), and 52 with Crohn's disease (CD) were investigated for anti-neutrophil cytoplasmatic antibodies (ANCA) and the polymorphism in the second exon of the motilin gene. Sixty unrelated blood donors served as controls. ANCA were found in 30% of UC and 13% of CD. In controls the DNA polymorphism identified two alleles (1 and 2) at a frequency of 42% and 58%, respectively. Patients with either UC or CD showed a slight increase in the frequency of allele 2 (69% and 60%, respectively; P > 0.05 vs controls). This allele was predominant in ANCA-positive CD patients (86%; P < 0.04) while in UC it did not differ. All ANCA-positive CD patients had the disease confined to the colon. A polymorphism of second exon of the motilin gene, leading to a protein variant, is significantly more frequent in the subset of ANCA-positive CD patients. This subgroup of patients appears to share peculiar genetic and clinical features.

Topics: Adult; Alleles; Antibodies, Antineutrophil Cytoplasmic; Case-Control Studies; Colitis, Ulcerative; Crohn Disease; Female; Genetic Variation; Humans; Male; Motilin; Polymorphism, Genetic

The authors consider different mechanisms participating in progression of diarrhea in ulcerative colitis. The involvement of osmotic component was suggested in view of incomplete hydrolysis of carbohydrates by small intestinal glucoamylase under mono- and bisubstrate digestion, whereas diarrhea secretory component develops in participation of cyclic nucleotides. Motor mechanism is also present in diarrhea as evidenced by high concentrations of blood motilin and changes in intestinal evacuation and motility. Polycomponent dysbioses detected in ulcerative colitis patients may also be essential for pathogenesis of diarrhea. Determination of the leading component in each diarrhea case is thought helpful in valid choice of individual therapeutic policy.

Topics: Adolescent; Adult; Colitis, Ulcerative; Diarrhea; Digestion; Digestive System; Female; Gastrointestinal Motility; Humans; Hydrogen-Ion Concentration; Hydrolysis; Intestinal Mucosa; Male; Middle Aged; Motilin; Nucleotides, Cyclic; Rectum

Motilin basal level and that after carbohydrate load were radioimmunoassayed in 26 patients with ulcerative colitis. The results were correlated with the data on motor evacuatory activity of the gastrointestinal tract and clinical manifestations of diarrhea. Basal motilin level was found elevated as against the control (99 rg/ml) in all the patients and surpassed the norm (356-1001 rg/ml) in 6. A significant elevation of motilin content was associated with reduction of the amplitude and number of rhythmic type I contractions, as well as by increased number of type III (propulsive) waves and accelerated transport of the contents via the small intestine. No compensatory rarefying of acid discharge from the stomach, that was observed in reference subjects if transport of contents was accelerated, was detectable in the patients with ulcerative colitis. This resulted in acidification of the enteral medium (pH 5.6 +/- 0.6). Concomitant pancreatitis in 22 patients with reduced production of HCO3- and impaired cavitary hydrolysis of polymer substrate enhanced enteral medium acidification and changed its osmotic pressure. Specific features of enteral medium homeostasis disorders and of impairments of the gastrointestinal tract motor evacuatory function should be borne in mind when planning treatment strategy for diarrhea patients.

Topics: Adult; Colitis, Ulcerative; Diarrhea; Duodenum; Female; Gastrointestinal Transit; Humans; Hydrogen-Ion Concentration; Jejunum; Male; Middle Aged; Motilin; Time Factors

Topics: Adolescent; Child; Child, Preschool; Colitis, Ulcerative; Crohn Disease; Diabetes Mellitus; Diarrhea; Humans; Infant; Infant, Newborn; Kidney Failure, Chronic; Motilin; Radioimmunoassay; Reference Values

We have studied fasting levels and the response to a standard test breakfast of blood glucose and several gut hormones in 24 patients with ulcerative colitis, in 14 patients with Crohn's disease, and in 14 healthy control subjects. Patients with ulcerative colitis had significantly elevated fasting human pancreatic polypeptide (HPP) concentrations, and both basal and postprandial levels of gastrin, gastric inhibitory polypeptide (GIP), and motilin were greater than normal. In contrast, patients with Crohn's disease had normal gastrin levels but had increased fasting and postprandial levels of GIP and motilin and, in addition, of enteroglucagon, compared with controls. These patients also had greater than normal HPP concentrations 30 min after the breakfast. Normal levels of insulin, pancreatic glucagon, neurotensin, and vasoactive intestinal polypeptide were found in both groups of patients. Much remains to be known about the pathophysiology of these two debilitating diseases, and the abnormal release of gut hormones may be of importance.

Topics: Adolescent; Adult; Aged; Blood Glucose; Colitis, Ulcerative; Crohn Disease; Female; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon-Like Peptides; Humans; Insulin; Male; Middle Aged; Motilin; Neurotensin; Pancreatic Polypeptide; Vasoactive Intestinal Peptide

Topics: Adult; Aged; Antibody Specificity; Chromatography, Gel; Colitis, Ulcerative; Epitopes; Female; Gastrointestinal Hormones; Humans; Ileum; Immunologic Techniques; Kidney Failure, Chronic; Male; Middle Aged; Motilin